This ppt is helpful for physiotherapy students # valuable nots... # study purpose, if you need more nots keep following

1. Autonomic nervous
system:
By – Dr. keerti gour
NEUROLOGY

2. COURSE CONTENT:-
 BREIF OVERVIEW OF ANS
 CLINICAL FEATURES OF
AUTONOMIC DISORDER
 AUTONOMIC DYSREFLEXIA
 AUTONOMIC NERVOUS SYSTEM
AND PAIN

3. BREIF OVERVIEW ON ANS
The autonomic nervous system is a part of the peripheral nervous
system that regulates involuntary physiologic processes including
heart rate, blood pressure, respiration, digestion, and sexual arousal.
 The autonomic nervous system (ANS), also known as
the vegetative nervous system , it is a division of the nervous
system that operates internal organs, smooth muscle and glands.
 The autonomic nervous system is a control system that acts
largely unconsciously and regulates bodily functions, such as
the heart rate, its force of contraction, digestion, respiratory
rate, pupillary response, urination, and sexual arousal.[2] This
system is the primary mechanism in control of the fight-or-flight
response.

4. TYPES AND ACTION OF ANS:
 : Sympathetic nervous system
 Promotes a fight-or-flight
response, corresponds with
arousal and energy generation,
and inhibits digestion
 Parasympathetic nervous system
 The parasympathetic nervous
system has been said to promote
a "rest and digest" response,
promotes calming of the nerves
return to regular function, and
enhancing digestion.

5. ANS DYSFUNCTION
 Autonomic Dysfunction is a medical condition used to describe the disabling function (or
failure) of the autonomic nervous system.
 Although the early stages of Autonomic Dysfunction is commonly asymptomatic,
advanced symptoms may include dizziness (syncope), fatigue, weakness and cognitive
impairment.
 Patients to Consider for Autonomic Nervous System (ANS) testing:
 Patients with Symptoms Suggesting Autonomic Dysfunction
 Syncope
 Orthostatic Hypotension
 Postural Tachycardia Syndrome (POTS)
 Pain / numbness in feet
 Numbness in hands
 Cardio Metabolic Syndrome
 Patients that suffer from affects associated with Long Covid

6. CONTINUE:
 Patients that suffer from affects associated with Long Covid
 Cardiac patients with silent ischemia
 Diabetic patients
 Pre-diabetic patients
 Impaired glucose tolerance
 Insulin resistance
 Blood pressure disorders
 Resting tachycardia
 Congestive heart failure
 Sleep Apnea
 Chronic pain in extremities
 Digestive disorders
 Patients with chronic inflammation
 Rheumatoid Arthritis

7. CLINICAL FEATURE OF ANS:-
 Signs and symptoms of autonomic neuropathy depend on which nerves are damaged. They
might include:
 Dizziness and fainting when standing, caused by a sudden drop in blood pressure.
 Urinary problems, such as difficulty starting urination, loss of bladder control, difficulty sensing a
full bladder and inability to completely empty the bladder. Not being able to completely
empty the bladder can lead to urinary tract infections.
 Sexual difficulties, including problems achieving or maintaining an erection (erectile
dysfunction) or ejaculation problems. In women, problems include vaginal dryness, low libido
and difficulty reaching orgasm.
 Difficulty digesting food, such as feeling full after a few bites of food, loss of appetite, diarrhea,
constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn.
These problems are all due to changes in digestive function.
 Inability to recognize low blood sugar (hypoglycemia), because the warning signals, such as
getting shaky, aren't there.
 Sweating problems, such as sweating too much or too little. These problems affect the ability
to regulate body temperature.
 Sluggish pupil reaction, making it difficult to adjust from light to dark and seeing well when
driving at night.
 Exercise intolerance, which can occur if your heart rate stays the same instead of adjusting to
your activity level.

8. Autonomic dysreflexia:
 Autonomic Dysreflexia (AD), also called autonomic hyperreflexia, which means
dysregulation of the autonomic nervous system, this leading to an uncoordinated
response to a noxious stimulus below the level of a spinal cord injury. It is a
common pathological life-threatening condition after a Spinal Cord Injury (SCI),
usually occurring with SCI is at or above the T6 level.
 AD is defined as an acute episode of systolic blood pressure elevated by 25 mm
Hg or above the patient’s normal measurements.
 It is characterized by a temporary rise in blood pressure that is proceeded by
hypotension, flaccid paralysis, urinary retention and fecal Urinary Incontinence.
 Signs and symptoms: sudden increase in blood pressure,
 altered heart rate (reflex bradycardia),
 anxiety, blurred vision, headache, flushing and sweating (above the level of
injury).

9. Pt management of AD:
 Physiotherapy Management
 In the event of an episode, the physiotherapist should perform the following steps:
 Sit the patient upright with their legs dangling (lying the patient down is contraindicated).
 Proper medical management
 Check catheter for kink, block, fullness (notify nurse to empty if needed)
 Remove any tight clothing or constrictive devices, which will help lower their blood
pressure by inducing the pooling of blood in the abdominal and lower extremity vessels as
well as eliminating possible triggering stimuli.
 Look for another potentially noxious stimulus below NLI.
 Vital signs should be closely monitored, and identification of the triggering stimulus should
be immediately attempted.
 Blood pressure should be checked at least every 5 minutes, and an arterial line should be
considered. The noxious stimuli should be corrected as soon as possible[14][5].
 Document.

10. AUTONOMIC NERVOUS SYSTEM AND PAIN
 The autonomic nervous system has important
actions on nociception. It reduces inflammation,
pain transmission and pain perception.
Sympathetic nervous system activation may
promote chronic pain syndromes.
 Autonomically mediated pain (AMP) is a
component of neuropathic pain controlled by
the two divisions of the autonomic nervous
system.
 Sympathetically mediated pain (SMP) :- it is
identified clinically as pain that does not follow a
specific dermatomal distribution but can be
relieved through sympathetic efferent blockade.
 causes : complex regional pain syndrome
 nerve injury
 posttraumatic neuralgia
 phantom limb pain
 herpes zoaster infection

11. THANK YOU